surgery and diabetes

[epalantequevoy]

i'm an m1 with type 1 diabetes and am planning to spend quite a bit of time in the or in may, most likely scrubbed in on most cases. i'm wondering if anyone knows anything about residents or attendings with type 1 diabetes, and what would be acceptable if i started to feel hypoglycemic during a longer case. hopefully this wouldn't happen often, but i'm sure it will eventually come up. should i tell the attending/resident about my diabetes beforehand, or should i just let them know if i need to scrub out to get some juice or something? also, would it ever be acceptable to have something on-hand in the or during one of these cases?

any ideas? thanks.

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[RichL025]

Well, if you start getting hypoglycemic, you'd better have something on-hand... contaminating a sterile field by passing out into it would be much worse than sucking a getl pack in a corner of the or after breaking scrub.

I knew an attending a few years back who has IDDM. He has an insulin pump that looked like just another beeper until he pointed it out to me. Pretty succesful guy.

 

[epalantequevoy]

yeah, i guess the gel pack would be a good option. i don't suppose there is any way to raise one's blood glucose without breaking scrub, but i guess that's not that big of a deal.

 

[njbmd]

i'm an m1 with type 1 diabetes and am planning to spend quite a bit of time in the or in may, most likely scrubbed in on most cases. i'm wondering if anyone knows anything about residents or attendings with type 1 diabetes, and what would be acceptable if i started to feel hypoglycemic during a longer case. hopefully this wouldn't happen often, but i'm sure it will eventually come up. should i tell the attending/resident about my diabetes beforehand, or should i just let them know if i need to scrub out to get some juice or something? also, would it ever be acceptable to have something on-hand in the or during one of these cases?

any ideas? thanks.

Hi there,
You should tell your resident and the circulating nurse before you scrub a long case. Often the circulating nurse will give you a sip of something if you let them know that you are having symptoms. It will not be a big deal if you just let them know.

njbmd 🙂

 

[Bigguns]

Hey, I'm also a type I diabetic. I'm a third year student who just finished my surgery rotation and am planning on going into surgery as a career. The long cases weren't bad at all. I just turned my pump down and usually ate something before the case began. Standing there for hours uses more energy than you might think. I also made the attendings and residents I was working with that I was diabetic. They were very accomodating and receptive. Even scrubbing out of the case and then scrubbing back in isn't that big of a deal, it only takes a couple of minutes. If you have any more questions about it feel free to let me know. Good Luck!

 

[Winged Scapula]

I have a colleague who's a TYPE 1 and wears an insulin pump. He adjusts it as the poster above does, and I am unaware of any problems to date while in the OR or during long days.

 

[tussy]

One of the other PGY5s in my program is a type I DM and he doens't have any problems. He also finds that the insulin pump is best (got it after a nasty bought of DKA that landed him in the ICU when he was a PGY2).

I'm not diabetic, but i tend to get a little hypoglycemic during long cases. when i'm scrubbing into a 6+ hour case i bring some candy, give it to the circulating nurse, and if i need one then she pulls down my mask and puts it in my mouth. Another option is to bring a bottle of juice and a straw and the nurse can hold the juice and straw and you can drink without breaking scrub.

As a first year student though, you're probably not "necessary" during the case and breaking scrub to get a quick snack won't be a problem.